Individual provider Active NPI

Maria Mangru, DPT

  • Physical Therapist
  • Sparta, NJ
National Provider Identifier
1841818440
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01927400 Issued in NJ
Practice address
8 Town Center Dr Ste 1
Sparta, NJ 07871-1989
Phone
(973) 726-3800
NPI assigned
Jul 9, 2020
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA01927400 NJ
Physical Therapist 225100000X 40QA01927400 NJ Primary

Addresses

Primary practice location

8 Town Center Dr Ste 1
Sparta, NJ 07871-1989

Mailing address

5 Carroll CT
Parsippany, NJ 07054-1706
Phone (862) 812-8676

Other practice location 1

197 Ridgedale Ave Ste 155
Cedar Knolls, NJ 07927-2198
Phone (973) 605-5115

Other identifiers 1

IdentifierTypeStateIssuer
40QA01927400OtherNJNJ STATE BOARD OF PT EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715001546 NJ Practitioner - Physical Therapist in Private Practice 0143643734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

8 Town Ctr Dr
Suite 1
Sparta, NJ 07871-1989
Phone (973) 726-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01927400NJMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare of America, PC Physical Therapist CurrentSince Jul 10, 2020 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Jul 10, 2020 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

197 Ridgedale Ave
Ste 155
Cedar Knolls, NJ 07927
Phone (973) 605-5115

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936

140 N Route 17
Ste 272
Paramus, NJ 07652
Phone (201) 261-4343

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

8 Town Center Dr
Ste 1
Sparta, NJ 07871
Phone (973) 726-3800

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

530 Lakehurst Rd
Ste 202204
Toms River, NJ 08755
Phone (732) 349-1201

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1841818440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CARROLL CT",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541706",
            "telephone_number": "862-812-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TOWN CENTER DR STE 1",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711989",
            "telephone_number": "973-726-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Ridgedale Ave Ste 155",
            "address_purpose": "LOCATION",
            "city": "Cedar Knolls",
            "state": "NJ",
            "postal_code": "079272198",
            "country_code": "US",
            "telephone_number": "973-605-5115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGRU",
        "first_name": "MARIA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01927400",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01927400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE BOARD OF PT EXAMINERS",
            "identifier": "40QA01927400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.